A Retrospective Review of 307 Men With Peyronie’s Disease

Abstract

No AccessJournal of UrologyCLINICAL UROLOGY: ORIGINAL ARTICLES1 Sep 2002A Retrospective Review of 307 Men With Peyronie's Disease Ateş Kadioglu, Ahmet Tefekli, Bulent Erol, Tayfun Oktar, Murat Tunc, and Sedat Tellaloglu Ateş KadiogluAteş Kadioglu , Ahmet TefekliAhmet Tefekli , Bulent ErolBulent Erol , Tayfun OktarTayfun Oktar , Murat TuncMurat Tunc , and Sedat TellalogluSedat Tellaloglu View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64578-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We discuss the clinical appearance and natural outcome of Peyronie's disease. Materials and Methods: During an 8-year period 307 men with Peyronie's disease were evaluated, and clinical characteristics, risk (factors), penile deformities, erectile status and outcome were analyzed. Results: Mean patient age plus or minus standard deviation was 52.8 ± 9.3 years (range 23 to 76). Penile deformity, pain on erection and palpable nodule were the most common (85%) presenting symptoms, usually in different combinations. The remaining 15% of men (mean age 59.4 ± 6.5 years) were not aware of the penile deformity and were diagnosed during standard evaluation for erectile dysfunction. Dorsal (45.6%) and lateral (29.3%) were the most common curvatures. The degree of deformity was less than 30 degrees in 42.7% of patients, 31 to 60 degrees in 38.8% and greater than 60 degrees in 18.6%. At least 1 risk factor for systemic vascular disease was identified in 67.5% of patients, and hypercholesterolemia and diabetes were the most common. Patients with at least 1 risk factor had a significantly higher risk for severe penile deformity. Of the men 54.4% complained of erectile dysfunction and the probability of diminished erectile capacity was 86.7% in patients older than 60 years, with Peyronie's disease for more than 12 months and at least 1 risk factor. Of 63 patients presenting with the acute phase of disease penile deformity deteriorated in 30.2%, did not change in 66.7% and resolved spontaneously in 3.2% without any treatment after a mean followup of 8.4 months. Conclusions: Our data show that penile deformities are disabling (greater than 30 degrees) in 62.5% of cases. Risk factors, such as serum lipid abnormalities, diabetes and hypertension, seem to have significant impact on the severity of symptoms and outcome. Patients must be informed that Peyronie's disease is progressive in 30.2% without treatment and spontaneous resolution is rare. References 1 : Peyronie's disease. Am J Clin Path1966; 45: 670. Google Scholar 2 : The anatomy of the tunica albuginea in the normal penis Peyronie's disease. J Urol1997; 157: 276. Link, Google Scholar 3 : Peyronie's disease: etiology, medical, surgical therapy. J Androl2000; 21: 347. Google Scholar 4 : Prevalence of Peyronie's disease—results of a 8,000 men survey. Eur Urol2000; 37: 58. Google Scholar 5 : The incidence of Peyronie's disease in Rochester, Minnesota, 1950 through 1984. J Urol1991; 146: 1007. Link, Google Scholar 6 : The natural history of Peyronie's disease. J Urol1970; 103: 75. Link, Google Scholar 7 : The natural history of Peyronie's disease. J Urol1990; 144: 1376. Link, Google Scholar 8 : Peyronie's disease. Plast Reconstr Surg1973; 52: 503. Google Scholar 9 : Color Doppler ultrasound assessment of penile vascular system in men with Peyronie's disease. Int J Impot Res2000; 12: 263. Google Scholar 10 : Impotence. NIH Consensus Development Panel on Impotence. JAMA1993; 270: 83. Google Scholar 11 : Does the positive intracavernous papaverine test always indicate a normal penile vascular system?. Eur Urol1997; 31: 323. Google Scholar 12 : Classification of congenital acquired penile deviation. Urol Int1983; 38: 229. Google Scholar 13 : A case-control study on risk factors for Peyronie's disease. J Clin Epidemiol1998; 51: 511. Google Scholar 14 : Penile trauma: an etiologic factor in Peyronie's disease erectile dysfunction. J Urol1997; 158: 1388. Link, Google Scholar 15 : Factors associated in the aetiology of Peyronie's disease. Br J Urol1982; 54: 748. Google Scholar 16 : The effect of surgical trauma on rat tunica albuginea. J Urol1998; 159: 1700. Link, Google Scholar 17 : An animal model of Peyronie's-like condition associated with an increase of transforming growth factor beta mRNA protein expression. J Urol1997; 158: 2284. Link, Google Scholar 18 : Peyronie's disease is associated with an increase in transforming growth factor- protein expression. J Urol1997; 158: 1391. Link, Google Scholar 19 : Basic fibroblast growth factor expression in Peyronie's disease. J Urol2001; 165: 419. Abstract, Google Scholar 20 : International Conference on Peyronie's disease introduction. J Urol1997; 157: 272. Link, Google Scholar 21 : Peyronie's disease in men under age 40: characteristics outcome. Int J Impot Res2001; 13: 18. Google Scholar 22 : Venous patch graft for Peyronie's disease.